Firearm-Related Deaths -- Louisiana and Texas, 1970-1990

In 1990, firearm-related injuries surpassed motor-vehicle
crashes as the leading cause of death from injuries in both
Louisiana and Texas, and from 1979 through 1987, these states
ranked third and fifth, respectively, for age-adjusted
firearm-related death rates * (1). Because firearm-related injuries
are a major cause of death in Louisiana and Texas, the Louisiana
Disability Prevention Program, Louisiana Office of Public Health,
and the Injury Control Program, Epidemiology Division, Texas
Department of Health, used death certificates to examine patterns
in firearm-related mortality. This report summarizes the analysis
of death certificate data for firearm-related mortality in these
two states.
Louisiana

In Louisiana, firearm-related deaths have been the leading
cause of injury-related mortality for 4 of the 5 years from 1986
through 1990. From 1970 through 1990, motor-vehicle-related death
rates declined by 30% (from 32.4 per 100,000 population to 22.6 per
100,000) while the rate for firearm-related deaths fluctuated
(Figure 1). Firearm-related death rates -- including homicide and
suicide -- increased most for black males (42%) from 1970 through
1990 (from 54.1 per 100,000 to 76.7 per 100,000). Although the
overall firearm-related death rate did not increase as dramatically
among white males (16% during 1970-1990), the firearm-related
suicide rate for white males increased 47%.

From 1985 through 1990, 5647 persons died as a result of
firearm-related injuries; of these deaths, 2677 (47%) were
suicides, 2591 (46%) were homicides, 321 (6%) were classified as
unintentional, 19 (0.3%) resulted from legal intervention, and 39
(0.7%) were of unknown intent. In 1990, males were 5.5 times more
likely to die from firearm-related injuries than were females (43.7
per 100,000 and 7.9 per 100,000, respectively); blacks were 2.2
times more likely to die from firearm-related injuries than were
whites.
Texas

During 1990, firearm-related injuries surpassed motor-vehicle
crashes as the leading cause of injury-related mortality in Texas
(2), the first state to report this pattern to CDC. From 1964
through 1989, deaths resulting from motor-vehicle crashes had been
the leading cause of injury mortality in Texas. Although death
rates for motor-vehicle crashes decreased by 42% from 1970 through
1990 (from 32.5 per 100,000 population to 18.8 per 100,000), the
firearm-related death rate remained relatively constant (Figure 2).

From 1985 through 1990, 19,184 persons died from
firearm-related injuries; of these deaths, 9286 (48%) were
suicides, 8581 (45%) were homicides, 1028 (5%) were classified as
unintentional, 114 (1%) resulted from legal intervention, and 175
(1%) were of unknown intent (2). Males were five times more likely
to die from firearm-related injuries than were females (31.3 per
100,000 versus 6.2 per 100,000). Age-specific rates were highest
for persons aged 25-34 years (28.9 per 100,000). Blacks were 1.9
times more likely to die from firearm-related injuries than were
Hispanics or whites (32.3 per 100,000 versus 17.4 per 100,000 and
16.8 per 100,000, respectively). The firearm-related death rate was
highest for black males (57.1 per 100,000).

Editorial Note

Editorial Note: The trends that led to the emergence of
firearm-related deaths as the leading cause of injury-related
mortality in Louisiana and Texas are similar to those for the
United States. Since 1966, the death rate for motor-vehicle
crashes ** in the United States has declined substantially (3) and
has been associated with a combination of interventions, including
the construction of safer highways and vehicles, reductions in the
levels of alcohol-impaired driving, lower speed limits, and
increased use of safety belts, motorcycle helmets, and child
passenger restraint devices (4). In comparison, during 1970-1990,
the firearm-related death rate has fluctuated; however, these rates
have been higher than at any time since the 1920s (5).

States, local communities, and school systems have employed a
variety of strategies to prevent firearm-related injuries and
deaths. An important element of many of these strategies is to
inhibit, restrict, or reduce immediate access to firearms in the
general population or in specific locations. For example, in 1976,
the District of Columbia banned the purchase, sale, transfer, or
possession of handguns by civilians. An evaluation of this
regulation found that it was associated with a 25% reduction in
firearm-related homicides, a 23% reduction in firearm-related
suicides, and an estimated 47 lives saved per year (6). In some
states and localities, firearms are prohibited from being carried
in public; in Detroit and in Massachusetts, legislation that
increased the penalty for violating such laws reduced the
occurrence of firearm-related homicides (7,8). In some school
systems, methods used to deter students from bringing firearms on
school grounds include random locker searches, walk-throughs with
metal detectors, and policies requiring that students use only
clear plastic or mesh bookbags so that weapons cannot be readily
hidden (9).

Community efforts to prevent firearm-related deaths should use
other measures in addition to reducing access to firearms. Suicide
may be prevented by improved identification and referral of persons
at increased risk (e.g., those suffering from clinical depression
or who exhibit suicidal behavior). Efforts to prevent homicide may
include reduction of the incidence of interpersonal violence
through behavioral and other interventions (e.g., conflict
resolution training and mentoring programs) (10). The reduction of
mortality from motor-vehicle crashes in Louisiana and Texas
illustrates how public health approaches can be used to control and
prevent injury. The application of such approaches to
firearm-related injury holds the potential for decreasing the
morbidity and mortality associated with this problem.

References

CDC. Injury mortality atlas of the United States, 1979-1987.
Atlanta: US Department of Health and Human Services, Public Health
Service, CDC, 1991.

In both state analyses, a firearm-related death was defined as
any
death with the underlying cause listed as codes E922.0-E922.9,
E955.0-E955.4, E965.0-E965.4, E970, or E985.0-E985.4 in the
International Classification of Diseases (ICD), 8th and 9th
revisions; a motor-vehicle-related death was defined as any death
with the underlying cause listed as codes E810.0-E825.0 in the ICD,
8th and 9th revisions.

** Measured as deaths per 100 million vehicle miles of travel.

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